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Evaluation of Cold Knife Conization(CKC)on Diagnosis and Treatment of Cervical Intraepit helial Neoplasia

Zhang Xun 1 ,Li Ling 1 ,Zhang Wen-Hua 2 ,Li Shu-Min 2  
BACKGROUND OBJECTIVE:Cold knife conization(CKC)is a classic diag nostic and therapeutic procedure.The authors analyzed patholog ical features of 62cone spe cimens and determined the effective ness of CKC on diag nosis and treatment of cer vical intraepithelial neoplasia(CIN).METHODS :Comparative analysis on patholog ic al finding s of cone specimens and multiple biopsies (MB)of 62CIN patients was performed.RESULTS :There were close similarities in pat holog y between CKC and MB in 44cases (71%).Eig hteen cases (29%)showed histolog ical difference bet ween CKC and MB;among them,4cases that were g iven a diag nosis of CIN2or CIN3by MB were classified into CIN3or micro invasive carcinoma by CKC.All 62cas es were squamous epithelial lesions ;34of them subjected to CIN3or hig her than CIN3.The lesions were mainly lo cated in transformation zone,mostly with cervical canal involvement.Thirty cases showed equal to or more than 2quadrants involved.Thirty-seven c ases (59.7%)had histolog ical evidences for HPV infection.Thirty-one cases (50%)had squamous metaplasia,some with variable dysplasia.Resection marg in positive rates were 3.2%(≥CIN2)and8.1%(CIN1),respectively,lower than those by l oop electrosurg ical excision procedure(Leep)reported in literature.Fifty-six c ases were closely followed up after operation(4months-14years).No recurrences were found and 3patients had preg nancy and delivery.CONCLUSION:CKC is sig nificantly effective and cannot be replaced by MB.Squamous me taplasia and CIN development are intrinsically correlated with each other.
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